Median Nerve Compression Syndromes. Literature Review and Update
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DOI:
https://doi.org/10.15417/issn.1852-7434.2023.88.4.1734Keywords:
Nerve compression, median nerve, pronator teres syndrome, carpal tunnel syndrome, surgical decompressionAbstract
The median nerve is a nervous structure that begins to cross structures at the level of the elbow that might cause compression. The Struthers ligament, lacertus fibrosus, pronator teres, and flexor digitorum superficialis are among them. Finally, the transverse carpal ligament creates another compression site in the wrist. All these structures can develop pathological signs and symptoms of nerve entrapment, which favors nerve functional degradation. Our objective is to provide an update on these median nerve entrapment sites, as well as information on how to establish an accurate diagnosis and provide adequate treatment.
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References
Adler JA, Wolf JM. Proximal median nerve compression: pronator syndrome. J Hand Surg Am 2020;45(12):1157-
https://doi.org/10.1016/j.jhsa.2020.07.006 DOI: https://doi.org/10.1016/j.jhsa.2020.07.006
Strohl AB, Zelouf DS. Ulnar tunnel syndrome, radial tunnel syndrome, anterior interosseous nerve syndrome, and pronator syndrome. Instr Course Lect 2017;66:153-62. PMID: 28594495
Rodner CM, Tinsley BA, O’Malley MP. Pronator syndrome and anterior interosseous nerve syndrome. J Am Acad Orthop Surg 2013;21(5):268-75. https://doi.org/10.5435/JAAOS-21-05-268 DOI: https://doi.org/10.5435/00124635-201305000-00003
Miller TT, Reinus WR. Nerve entrapment syndromes of the elbow, forearm, and wrist. AJR Am J Roentgenol 2010;195(3):585-94. https://doi.org/10.2214/AJR.10.4817 DOI: https://doi.org/10.2214/AJR.10.4817
Xing SG, Tang JB. Entrapment neuropathy of the wrist, forearm, and elbow. Clin Plast Surg 2014;41(3):561-88.
https://doi.org/10.1016/j.cps.2014.03.007 DOI: https://doi.org/10.1016/j.cps.2014.03.007
Tang DT, Barbour JR, Davidge KM, Yee A, Mackinnon SE. Nerve entrapment: update. Plast Reconstr Surg
;135(1):199e-215e. https://doi.org/10.1097/PRS.0000000000000828 DOI: https://doi.org/10.1097/PRS.0000000000000828
Simpson RL, Fern SA. Multiple compression neuropathies and the double-crush syndrome. Orthop Clin North Am 1996;27(2):381-8. PMID: 8614586 DOI: https://doi.org/10.1016/S0030-5898(20)32081-2
Mooar PA, Doherty WJ, Murray JN, Pezold R, Sevarino KS. Management of carpal tunnel syndrome. J Am Acad
Orthop Surg 2018;26(6):e128-30. https://doi.org/10.5435/JAAOS-D-17-00451 DOI: https://doi.org/10.5435/JAAOS-D-17-00451
Graham B, Peljovich AE, Afra R, Cho MS, Gray R, Stephenson J, et al. The American Academy of Orthopaedic
Surgeons Evidence-Based Clinical Practice Guideline on: Management of Carpal Tunnel Syndrome. J Bone Joint
Surg Am 201619;98(20):1750-4. https://doi.org/10.2106/JBJS.16.00719 DOI: https://doi.org/10.2106/JBJS.16.00719
Karamanos E, Jillian B-Q, Person D. Endoscopic carpal tunnel release: indications, technique, and outcomes.
Orthop Clin North Am 2020;51(3):361-8. https://doi.org/10.1016/j.ocl.2020.02.001 DOI: https://doi.org/10.1016/j.ocl.2020.02.001
Li Y, Luo W, Wu G, Cui S, Zhang Z, Gu X. Open versus endoscopic carpal tunnel release: a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskelet Disord 2020;21(1):272. https://doi.org/10.1186/s12891-020-03306-1 DOI: https://doi.org/10.1186/s12891-020-03306-1
Lauder A, Mithani S, Leversedge FJ. Management of recalcitrant carpal tunnel syndrome. J Am Acad Orthop Surg 2019;27(15):551-62. https://doi.org/10.5435/JAAOS-D-18-00004 DOI: https://doi.org/10.5435/JAAOS-D-18-00004
Dellon AL, Mackinnon SE. Chronic nerve compression model for the double crush hypothesis. Ann Plast Surg
;26(3):259-64. https://doi.org/10.1097/00000637-199103000-00008 DOI: https://doi.org/10.1097/00000637-199103000-00008
Novak CB, Mackinnon SE. Multilevel nerve compression and muscle imbalance in work-related neuromuscular disorders. Am J Ind Med 2002;41(5):343-52. https://doi.org/10.1002/ajim.10063 DOI: https://doi.org/10.1002/ajim.10063
Löppönen P, Hulkkonen S, Ryhänen J. Proximal median nerve compression in the differential diagnosis of carpal tunnel syndrome. J Clin Med 2022;11(14):3988. https://doi.org/10.3390/jcm11143988 DOI: https://doi.org/10.3390/jcm11143988
Hagert E. Clinical diagnosis and wide-awake surgical treatment of proximal median nerve entrapment at the elbow: a prospective study. Hand (N Y) 2013;8(1):41-6. https://doi.org/10.1007/s11552-012-9483-4 DOI: https://doi.org/10.1007/s11552-012-9483-4
Barnett SA, Shah SA, Ahmad RI. Endoscopic proximal median nerve decompression: an alternative treatment for pronator syndrome. J Hand Surg Glob Online 2021;3(4):210-4. https://doi.org/10.1016/j.jhsg.2021.03.006 DOI: https://doi.org/10.1016/j.jhsg.2021.03.006
Naik AA, Bawa A, Arya A, Gulihar A. Nerve entrapment around elbow. J Clin Orthop Trauma 2021;19:209-15.
https://doi.org/10.1016/j.jcot.2021.05.031 DOI: https://doi.org/10.1016/j.jcot.2021.05.031
Tang JB. Median nerve compression: lacertus syndrome versus superficialis-pronator syndrome. J Hand Surg Eur Vol 2021;46(9):1017-22. https://doi.org/10.1177/17531934211024092 DOI: https://doi.org/10.1177/17531934211024092
Özdemir A, Acar MA, Güleç A, Durgut F, Cebeci H. Clinical, radiological, and electrodiagnostic diagnosis of
pronator syndrome concurrent with carpal tunnel syndrome. J Hand Surg Am 2020;45(12):1141-7. https://doi.org/10.1016/j.jhsa.2020.06.006 DOI: https://doi.org/10.1016/j.jhsa.2020.06.006
Lalonde D. Lacertus syndrome: a commonly missed and misdiagnosed median nerve entrapment syndrome. BMC Proc 2015;9(Suppl 3):A74. https://doi.org/10.1186/1753-6561-9-S3-A74 DOI: https://doi.org/10.1186/1753-6561-9-S3-A74
Zancolli ER, Zancolli EP, Perrotto CJ. New mini-invasive decompression for pronator teres syndrome. J Hand Surg Am 2012;37(8):1706-10. https://doi.org/10.1016/j.jhsa.2012.05.033 DOI: https://doi.org/10.1016/j.jhsa.2012.05.033
Hsiao CW, Shih JT, Hung ST. Concurrent carpal tunnel syndrome and pronator syndrome: A retrospective study of 21 cases. Orthop Traumatol Surg Res 2017;103(1):101-3. https://doi.org/10.1016/j.otsr.2016.10.009 DOI: https://doi.org/10.1016/j.otsr.2016.10.009
Andreisek G, Crook DW, Burg D, Marincek B, Weishaupt D. Peripheral neuropathies of the median, radial, and
ulnar nerves: MR imaging features. Radiographics 2006;26(5):1267-87. https://doi.org/10.1148/rg.265055712 DOI: https://doi.org/10.1148/rg.265055712
Kim S, Choi J-Y, Huh Y-M, Song H-T, Lee S-A, Kim SM, et al. Role of magnetic resonance imaging in entrapment
and compressive neuropathy--what, where, and how to see the peripheral nerves on the musculoskeletal magnetic resonance image: part 2. Upper extremity. Eur Radiol 2007;17(2):509-22. https://doi.org/10.1007/s00330-006-0180-y DOI: https://doi.org/10.1007/s00330-006-0180-y
Choi S-J, Ahn JH, Ryu DS, Kang CH, Jung SM, Park MS, et al. Ultrasonography for nerve compression syndromes of the upper extremity. Ultrasonography 2015;34(4):275-91. https://doi.org/10.14366/usg.14060 DOI: https://doi.org/10.14366/usg.14060
Cohen BH, Gaspar MP, Daniels AH, Akelman E, Kane PM. Multifocal neuropathy: expanding the scope of double crush syndrome. J Hand Surg Am 2016;41(12):1171-5. https://doi.org/10.1016/j.jhsa.2016.09.009 DOI: https://doi.org/10.1016/j.jhsa.2016.09.009
Lee AK, Khorsandi M, Nurbhai N, Dang J, Fitzmaurice M, Herron KA. Endoscopically assisted decompression for pronator syndrome. J Hand Surg Am 2012;37(6):1173-9. https://doi.org/10.1016/j.jhsa.2012.02.023 DOI: https://doi.org/10.1016/j.jhsa.2012.02.023
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